tbuckley/cabot-search huggingface dataset:
Oral Presentation No. 46 The effect of covid-19 vaccine on the endothelial function
Authors: Ahmed Makni, Aiman Ghrab, Rania Gargouri, Salma Charfeddine, Amine Bahloul, Tarek Ellouze, Rania Hammami, Faten Triki, Mariem Jabeur, Souad Mallek, Leila Abid
Journal: Cardiovascular Research (2022)

Abstract Background Covid-19 vaccine was associated with several complications such as thromboembolic complications. The exact mechanism is not well established. Since covid 19 virus caused severe endothelial dysfunction, we suspect that the vaccine with a similar immunological response may cause this dysfunction. Aim To study the effect of covid-19 vaccine on endothelial function. Methods We conducted a prospective study. The endothelial function was clinically assessed using a post-occlusive reactive hyperemia protocol with finger thermal monitoring device. Endothelial quality index (EQI) was assessed at inclusion before the first dose of coronavirus vaccine and 30 days later. Results 20 patients were included in our study. Their mean age was 41 years old [23–65]. The sex ratio was 3/2. They were all healthy individuals. The Majority, 75% of our patients, have impaired their endothelial function 30 days after the first dose of covid-19 vaccine. Conclusion The Covid-19 vaccine effect on endothelial function may be responsible for its complications. Key words: Covid-19 vaccine, endothelial dysfunction
Poster No. 108 Effectiveness and safety of P2Y12 inhibitor pretreatment for primary PCI in STEMI: Systematic review and meta-analysis
Authors: João Presume, Daniel Gomes, Jorge Ferreira, Francisco Albuquerque, Manuel Sousa Almeida, Miguel Sousa Uva, Carlos Aguiar, Miguel Mendes
Journal: Cardiovascular Research (2022)

Abstract Double antiplatelet therapy (DAPT) with both aspirin and P2Y12 inhibitors in patients with STEMI has been shown to be associated with better clinical outcomes. Yet, there is uncertainty regarding the optimal timing for its initiation. This study is a systematic review and meta-analysis of the current evidence on pretreatment with P2Y12 inhibitors in patients with STEMI submitted to primary percutaneous coronary intervention (PCI). We performed a systematic search of electronic databases Pubmed, CENTRAL and Scopus until April/22. Studies were considered eligible if they were comparing P2Y12 inhibitor upstream administration vs. downstream use in patients with STEMI submitted to PCI. Studies with patients treated with fibrinolysis or medical therapy only were excluded. Outcomes were assessed at the shortest follow-up available. Out of 2336 articles, 18 studies were included (3 RCT and 17 non-RCT), with a total of 79300 patients (52439 in the pretreatment arm). Pretreatment was associated with a reduction in definite stent thrombosis (OR 0.59 [0.37–0.94]), all-cause death (OR 0.77 [0.60–0.97]) and cardiogenic shock (OR 0.60 [0.48–0.75]). It was also associated with lower incidence of TIMI flow &amp;lt; 3 pre-PCI (OR 0.78 [0.67–0.92]). However, it was not associated with a significant reduction in recurrent MI (OR 0.93 [0.57–1.52]). Regarding safety outcomes, pretreatment was not associated with higher risk of major bleeding events (OR 0.83 [0.75–0.92]). Pretreatment with DAPT, including a P2Y12 inhibitor, was associated with better pre-PCI coronary perfusion, lower risk for definite stent thrombosis, cardiogenic shock, and all-cause mortality. No sign of potential harm from this approach was encountered.
Poster No. 140 Major cardiovascular events in high cardiovascular risk patients submitted to non-cardiac surgery and its clinical determinants
Authors: Mariana Ferreira Carvalho, Carolina Gonçalves, Margarida Cabral, Sara Lopes Fernandes, Rita Ribeiro Carvalho, Jorge Guardado, Alexandre Antunes, João Morais
Journal: Cardiovascular Research (2022)

Abstract Introduction Pre-operative cardiovascular assessment of patients with high ischaemic risk is fundamental to give the best perioperative management. Morbi-mortality is mainly due to patient-related risk and surgery-related risk. However, the risk scores are very heterogeneous and derived from non-cardiac populations, making them less accurate. Purpose The study aims to characterize a cohort of patients with high ischemic risk who underwent non-cardiac surgery and to identify predictors of perioperative major adverse cardiovascular events (MACE) defined by urgent revascularization, myocardial infarction (MI) and/or cardiac death, thromboembolism and acute limb ischemia. Methods A single-center retrospective observational analysis between January 2015 and August 2022 evaluated 356 patients. Eligibility criteria included: patients with high cardiovascular risk with previous diagnosis of cardiac disease, planned to be submitted to high-risk non-cardiac surgery, and perioperative follow-up at our center. Results A total of 356 patients with high cardiovascular risk undergoing NCS were eligible in the cohort. Perioperative MACE occurred in 4.5% of the patients. Predictors of MACE during perioperative period were older age (P &amp;lt; 0.001), chronic pulmonary disease (P = 0.031), coronary artery disease (CAD) (P = 0.011) and valvular heart disease (P = 0.039). Diabetes and hypertension exhibited a neutral impact in these patients. Conclusions These results highlight the increased thrombotic risk inherent to major surgery in patients with high risk cardiovascular disease. Older age, previous diagnosis of chronic pulmonary disease, coronary artery disease, and valvular heart disease are predictors of MACE in patients submitted to non-cardiac surgery, providing incremental value for predicting these events. More studies are needed to further caracterize this population.x
Oral Presentation No. 125 Relation of non-invasively measured ankle-brachial index and pulse-wave velocity towards all-cause mortality in unselected emergency department patients - a prospective cross-sectional study
Authors: Sebastian Schnaubelt, Felix Eibensteiner, Julia Oppenauer, Hans Domanovits, Oliver Schlager
Journal: Cardiovascular Research (2022)

Abstract Background Increased pulse-wave velocity (PWV) and decreased ankle-brachial index (ABI) are related to an increased risk of all-cause- as well as cardiovascular mortality. Aim of this study was to assess the predictive value of PWV and ABI in an emergence department (ED) setting. Methods We assessed ABI-, brachial-ankle (ba) PWV-, and carotid-femoral (cf) PWV in patients presenting to a high-volume tertiary care ED. Primary outcome was all-cause mortality in the long-term follow-up of these patients, which was evaluated via Austria´s federal statistical office. Results We included 1,041 patients (60 ± 17 years; 56.6% males) with various chief complaints (e.g., chest pain, dyspnea, atrial fibrillation). ABI and cfPWV could be measured in 952 (91.5) and 910 (87.4%), respectively. Values of ABI (1.03 ± 0.13) and cfPWV (10.1 ± 2.9 m/s) were found to be pathological in 13.4% and 44.8%, respectively. Median follow-up time was 540 [344–877] days. During this observational period, 8.1% of patients had died; the majority of deaths was classified as cardiovascular events. Overall mortality differed significantly between patients with pathological ABI or elevated cfPWV (P &amp;lt; 0.001) compared with those patients without pathological alterations. Even after multivariate cox-proportional hazard analysis (including age(-groups), sex, BMI and comorbidities), a pathological ABI (HR 0.07 [0.01–0.56], P = 0.01) and cfPWV (HR 1.13 [1.04–1.23], P = 0.003) were associated with overall mortality risk. Conclusion In unselected ED patients a pathological ABI or PWV are independent predictors for long-term mortality and may be used as an additional risk stratification tool in the emergency setting.
Poster No. 025 Survival in octogenarians receiving implantable cardiac defibrillators: a single centre experience
Authors: Nitish Behary Paray, Nikolaos Spinthakis, Mohammad Saddam Jeelani, Jebby Kuriakose
Journal: Cardiovascular Research (2022)

Abstract Although the efficacy of implantable cardiac defibrillator (ICD) in preventing sudden cardiac death is well established in studies, patients ≥ 80 years are poorly represented, causing a paucity of data on outcomes in this subgroup. In our single-centre retrospective study, data pertaining to patients &amp;gt; or = 80 years of age at device implant (n = 95) between January 2010 and January 2022 was extracted from device databases and clinical notes. Categorical variables were compared using Fisher's exact test. A Kaplan-Meier survival analysis with logrank test was performed. A Multivariable Cox Hazard regression model was used to analyse survival adjusting for QRS duration, left ventricular ejection fraction and device type. Mean age of the cohort was 83.1 ± 3 years, with 85% (n = 81) being male. 73% (n = 69) of the population had ischaemic cardiomyopathy and 43% (n = 41) met the primary prevention indications. Median survival time post device implantation was 27 months. Survival at 5 years was 80%. The difference in survival rates between primary and secondary prevention groups was not statistically significant. Inappropriate shocks were delivered in 2 patients while 14 patients were successfully treated with appropriate therapy. Complications were encountered in 9% (n = 9) of cases, with a fatal outcome on one occasion. ICD therapy is a well-tolerated intervention and may confer survival benefits in elderly patients, provided careful selection criteria are implemented. Advanced chronological age alone should not unduly influence the decision for ICD selection for survival benefit. There is an imperative for greater representation of this cohort in future trials.
Oral Presentation No. 096 Impact of Inflammatory and Hematological Factors to The Left Ventricule Function, Remodeling, and Clinical Outcomes after The First Myocardial Infarction
Authors: Nina Korac, Milica Dekleva
Journal: Cardiovascular Research (2022)

Abstract Background It is known that hematological and inflammatory factors can affect the prognosis of patients with AMI, but the interpretations are different. Material and methods The study included 182 patients with their first AMI age &amp;lt; 70 years. Inflammatory (CRP, Sedimentation and Leukocytes), hematological factors (Platelets, Iron, Hct) and coronary status were obtained at admission. Doppler echocardiography was performed two days after admission and after 6 months.The degree of heart failure was assessed by clinical examination. Results and conclusions Remodeling of LV, measured by LV volume increase and Sphericity index was closely related to Sedimentation level (P = 0.013; P = 0.028). Sedimenation was related to systolic function measured by LVEF (P = 0.011) and with diastolic dysfunction measured by E/e ratio (P &amp;lt; 0.001). A significant impact of CRP on LVEF (P = 0.028) and degree of diastolic dysfunction (P = 0.024) was estimated. Iron level had an effect on LVEF (P = 0.017), while E/e was negatively correlated with Iron (P = 0.005). The degree of heart failure was positively correlated with the level of Iron and Sedimentation. Sedimentation level of 22.5 cut off had a sensitivity of 75%, a specificity of 52% in predicting NYHA III and IV. Iron level of 8.1 has a sensitivity of 72.4%, specificity of 57.9% in predicting NYHA III and IV. There were no significant correlations between coronary status and inflammation parameters .Inflammatory hematological status of patients is associated with changes in the morphology and function of the LV after the first MI. The sedimentation level and CRP contribute to a better risk stratification for the severity of heart failure.
Oral Presentation No. 55 Is White Blood Count a Good Marker to Coronary Disease Risk?
Authors: Débora Sá, Roberto Palma Dos Reis, Margarida Temtem, Marina Santos, Ana Célia Sousa, Sónia Freitas, Eva Henriques, Mariana Rodrigues, Sofia Borges, Ilídio Ornelas, António Drumond, Maria Isabel Mendonça
Journal: Cardiovascular Research (2022)

Abstract Background High white blood cells (WBC) count is a well-recognized indicator of inflammation. Previous research has considered it a risk factor for coronary artery disease (CAD). Other new inflammatory risk markers are expensive to test, are not readily available, lack standardization and have not been confirmed as risk markers by multiple prospective studies. We aim to investigate whether elevated WBC count representsan independent risk factor for CAD in our Portuguese population. Material and methods A case-control study with 3,160 individuals (mean age 53.1 ± 7.8; 77.6% male), namely 1,723 coronary patients and 1,437 controls, was performed. Together with WBC, the following CAD risk factors were analyzed: smoking, hypertension, diabetes, dyslipidemia and obesity through bivariate analysis. Multivariate logistic regression evaluated the independent risk factors for CAD. Results and conclusions Comparing cases with controls, 47.2% were smokers vs. 23.8% (P &amp;lt; 0.0001); 71.0% were hypertensive individuals vs. 52.3% (P &amp;lt; 0.0001); 89.0% had dyslipidemiavs 70.4% (P &amp;lt; 0.0001); 33.8% had diabetes vs. 13.2% (P &amp;lt; 0.0001) and 34.2% were obese patients vs. 28.9% (P = 0.001). After multivariate regression, smoking (OR = 3.14, P &amp;lt; 0.0001), diabetes (OR = 2.89, P &amp;lt; 0.0001), dyslipidemia (OR = 2.72, P &amp;lt; 0.0001), hypertension (OR = 1.95, P &amp;lt; 0.0001) and WBC (OR = 1.05, P = 0.035) remained as independent risk factors for CAD. Elevated white blood counts are associated with CAD risk in our population. This marker is inexpensive, widely available and may further predict inflammation and coronaryartery disease risk.
Poster No. 049 Cardiopreventive influence of Klotho protein on antioxidant and anti-apoptotic mechanisms in heart injured by ischemia/reperfusion
Authors: Agnieszka Olejnik, Marta Banaszkiewicz, Anna Radajewska, Iwona Bil-Lula
Journal: Cardiovascular Research (2022)

Abstract Background Ischemia/reperfusion injury (IRI) of heart involves activation of oxidative and apoptotic pathways. Klotho protein has potential protective activity since it supports redox balance and metabolic functions of cardiomyocytes. This study aimed to evaluate effect of Klotho protein on oxidative stress and apoptosis in hearts subjected to IRI. Material and methods Isolated rat hearts perfused with the Langendorff method were subjected to ischemia, followed by reperfusion, in presence or absence of Klotho protein. Heart mechanical function and factors involved in the activation of insulin-like growth factor 1 receptor (IGFR-1)/phosphoinositide 3-kinase (PI3K) signaling pathway were evaluated. Results Infusion supply of Klotho significantly increased (P = 0.001) mechanical function of hearts injured by IRI. IRI caused activation of IGFR-1/PI3K signalling pathway (P = 0.004; P = 0.003), while Klotho suppressed phosphorylation of IGFR-1 (P = 0.208) and PI3K (P = 0.022). Transcriptional activity of forkhead box protein O1 (FOXO1) and FOXO3 was reduced (P = 0.002; P &amp;lt; 0.001) in IRI hearts. Administration of Klotho decreased phosphorylation of FOXO1 (P = 0.587) and FOXO3 (P = 0.027) in IRI + Klotho group, while activity of glutathione peroxidase and superoxide dismutase was increased (P = 0.045; P = 0.006), and level of hydrogen peroxide and lipid peroxidation was slightly decreased (P = 0.502; P = 0.436), as compared to IRI hearts. Klotho protein contributed to reduction in caspase-9 level (P = 0.009) during IRI. Conclusion Administration of Klotho resulted in full preservation of heart mechanical function, and suppression of oxidative stress and apoptosis in IRI hearts. Thus, Klotho can be recognized as a novel cardiopreventive agent in ischemic damage. Funding Ministry of Science and Higher Education in Poland [grant number SUBK.D010.22.035].
Retracted: Poster No. 022 Partial atresia of the inferior vena cava associated with deep vein thrombosis – case report
Authors: Stoia Oana, Cristina Zagoni, Andreea Puia, Bianca Catrina, Minodora Teodoru
Journal: Cardiovascular Research (2022)

This abstract has been withdrawn. Please see: https://doi.org/10.1093/cvr/cvac183
Poster No. 116 Hemodynamic characteristics associated with partial thrombosis of the false lumen in patients with chronic aortic dissection of the descending aorta: a 4D flow CMR study
Authors: Aroa Ruiz Muñoz, Andrea Guala, Lydia Dux-Santoy, Gisela Teixidó-Turà, Juan Garrido-Oliver, Ana Garcia-Duran, Filipa Valente, Laura Galian-Gay, Laura Gutierrez, Hug Cuellar-Calabria, Kevin Johnson, Oliver Wieven, Ignacio Ferreira-Gonzalez, Arturo Evangelista, Jose Rodriguez-Palomares
Journal: Cardiovascular Research (2022)

Abstract Background Partial thrombosis of the false lumen (FL) in patients with chronic aortic dissection (AD) of the descending aorta has been associated with faster aortic dilation. Four-dimensional phase-contrast cardiovascular magnetic resonance (4D flow CMR) studies analyzing flow dynamics and biomechanics in the FL and their relationship with partial thrombosis are lacking. This study aimed to compare FL flow dynamics and biomechanics between patients with a patent and partially thrombosed FL. Materials and methods Patients with a chronic, patent (no thrombus) or partially thrombosed FL in the descending aorta after an AD underwent an imaging follow-up including a magnetic resonance angiography (MRA) and a 4D flow CMR study. FL thrombosis was quantified as the ratio of thrombus volume and FL volume on MRA. FL flow dynamics was assessed in terms of forward flow, wall shear stress (WSS), maximum kinetic energy (KE) and acceleration, and flow stasis on 4D flow CMR. Aortic stiffness in the FL was quantified using pulse wave velocity (PWV). Results and conclusions Sixty-five patients with a complete imaging protocol were included in the study (patency in 34 patients, partial thrombosis in 31). Partial thrombosis of the FL was associated with a reduction in the amount and energy of flow in the FL (reduced forward systolic flow, KE and acceleration), and a more stagnated flow in the FL (increased flow stasis). Axial WSS showed a tendency to be lower in the partial thrombosis group compared to the patency group, while PWV were similar in both of them. Funding IJC2018-037349-I.
Poster No. 106 Can we optimize d-dimer cut off value to predict pulmonary embolism in covid-19 patients?
Authors: Rafaela Fernandes, Joana Moura Ferreira, Ana Rita Alves, Gabriela Almeida, Vanessa Lopes, Gil Cunha, Gonçalo Costa, Eric Monteiro, Joana Guimarães, Diogo Fernandes, Ana Rita Gomes, João Borges Rosa, Gustavo Campos, Diana Campos, Carolina Loureiro, José Paulo Almeida, Sofia Martinho, Paulo Martins, Lino Gonçalves
Journal: Cardiovascular Research (2022)

Abstract Background Covid-19 is associated with an increased risk of pulmonary embolism (PE) therefore, should the cut off d-dimer value be adjusted for these patients? Material and methods Retrospective and observational study to understand if there is a d-dimer cut-off that could guide clinics to perform a thoracic computed tomography angiography (CTA) in patients with covid-19. The population was covid-19 patients admitted to covid-19 dedicated wards of a University Hospital Centre for one year. Results and conclusions 725 (52%) patients with covid-19 had a d-dimer value dosed during the first 5 days of the disease. Those, 63 (9%) did a CTA with a diagnosis of 16 (25%) PE. Gender was equally represented, median age was 70 years (ID = 3.49) and the majority (94%) survived. Thirteen (81%) patients with PE had a d-dimer value above 2500 ng/mL (OR = 9.244, 95% CI 2.248–9.837), with 7 (54%) with values over 10000 ng/mL, but in 3 (9%) it was under 1500 ng/mL. Seventy-three (63%) of patients with a d-dimer over 1500 ng/mL did not had a thoracic CTA performed. In our population PE was not a frequent outcome. The results are influenced by the low number of thoracic CTA performed because, even tough the cut-off d-dimer value used at our hospital to perform a thoracic CTA to exclude PE is 1500 ng/mL, most patients with that d-dimer value did not take the exam and so PE could not be excluded. Although in most PE cases the d-dimer value was above 2500 ng/mL, the results of our study cannot verify if that is a better cut-off value.
Poster No. 052 The Influence of the CYP2C9 polymorphisms on the treatment with clopidogrel: combined data from the POPular Genetics &amp; POPular AGE trials
Authors: W W A Van Den Broek, N Mani, J Azzahhafi, J Ten Berg
Journal: Cardiovascular Research (2022)

Abstract Background The CYP2C9-enzym plays a role in the metabolization of clopidogrel. In patients treated with clopidogrel, carriage of a CYP2C9 loss-of-function (LoF) allele has been associated with attenuated pharmacokinetics leading to a diminished pharmacodynamic response and increased risk for stent thrombosis. Material and methods We aimed to determine the effect of the CYP2C9*2 and *3 LoF-alleles on thrombotic events and clopidogrel treatment discontinuation. A post-hoc analysis was performed in patients with available CYP2C9 genotype status included in the POPular Genetics and POPular Age trials, which enrolled patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction, respectively. The primary thrombotic outcome was a composite of cardiovascular death, myocardial infarction or stroke. Results The CYP2C9 genotype was available in 2,257 patients, of which 878 were treated with clopidogrel (352 [40%] CYP2C9 LoF-allele carriers and 526 [60%] CYP2C9 LoF-allele noncarriers). There were no significant differences between CYP2C9 LoF-allele carriers and noncarriers for the combined thrombotic outcome (6.3% vs. 5.9%, HR 1.17 [0.67–2.03], P = 0.58), and the individual thrombotic outcomes. No differences were seen in clinically relevant bleeding (Bleeding Academic Research Consortium [BARC] 2–5 bleeding) as well as major bleeding (BARC 3 or 5 bleeding). Discontinuation rates for clopidogrel due to side-effects were numerically lower in CYP2C9 LoF carriers compared noncarriers (1.4% vs. 3.2%, HR 0.54 [0.26–1.13], P = 0.10), however this difference was not statistically significant. Conclusions Carriage of the CYP2C9 *2 or *3 LoF-alleles did not show an association with an increased thrombotic risk in patients treated with clopidogrel. Funding ZonMW.
Clinical Case 18—Management of patient with cancer and confirmed systemic thrombosis and rectal bleeding
Authors: Moskalenko Kateryna, Levenko Evgeny, Lysak Zoreslava, Doronina Myroslava, Yukish Oleh
Journal: Cardiovascular Research (2022)

Abstract A 55-year-old patient has been suffering from prostate cancer since February 2020. He received radiotherapy and developed disease progression in June 2021. Pt was started on chemotherapy with positive dynamic per CT scan. There was a worsening of anemia, and erythropoietin was prescribed, with not significant improvement. During planned CT scan monitoring, pulmonary embolism of medial and distal segments of the left and distal parts of the right pulmonary artery was revealed. Pt had dyspnea on mild exertion, tachycardia at rest and left leg edema (which was present earlier and considered as lymphedema that time). Thrombosis of the left popliteal vein was confirmed. Pt was started on rivaroxaban 15 mg BID. In 5 days, he reported rectal bleeding. Hb was 71 g/l. Rivaroxaban was stopped. Proctological examination was not informative, due to bleeding. Tranexamic acid and IV iron were started. The attempt to add prophylaxis dose of enoxaparin increased bleeding and was stopped immediately. In 5 days, he underwent colonoscopy. Disease progression, severe hemorrhoids were excluded. Findings were considered as radiation proctitis. Sulfasalazine was added. In 2 weeks Hb = 91 g/l, however, patient has episodes of the rectal bleeding 1–2 times per week. He doesn’t receive recurrent PE prevention with no worsening of clinical picture. Our strategy is to reassess bleeding risk after 1 month of treatment with sulfasalazine and to start prevention doses of DOACs. Conclusion: In complex clinical situations prevention of thrombosis should be based on patient-related risk factors, must be flexible and reviewed more often and thoroughly.